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Home My WebLink About25-3398 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 25-3398 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#TRIBAL OF OZ OBJECT 1 1 7 28 UNITS RESERVATION I I STRUCK z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 04 - 1-- 2025 1214 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e✓ --- ----� ❑ S 43RD ST MILEPOST 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e TALBOT RD S 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4258903375 0 7 30 6 LAST NAME LARA LOPEZ FIRST NAME EDWIN MIDDLE A 1 2 31 INITIAL STREET ❑ 12660 SE 165TH ST CITY RENTON ST WA Zlp' 98508 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 LICENSE CAG6204 sTArI WAurN# JNKCV61F69M360737 10❑ PI ATE 14 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR 2009 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 9 9 34 13 4 INFI G37 SD DAMAGE YES NOBS YYES[:] No✓ REGISTERED OWNER INFO JOSE LARA VALDEZ 12660 SE 165TH ST RENTON WA 98058 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 9TOP VEHICLE 5 36 15❑ STANDING E�ALLv YES No clTAnoN# 5AO407888 CHARGE INATTENTIVE DRIVING o eorrom 8 7 6 MOTOR PEDAL- ''.PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 a UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4258305558 LAST NAME SACOMANO FIRST NAME ANTOINETTE MIDDLE I L INITIAL 17❑ STREET ❑', 16316 SE 165TH ST CITY RENTON ST WA ZIP 980588221 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCK YES❑NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 DRIVER'S STATE WA SEX F D.O.B. 10 _ 10 _ 1960 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE BCV7303 TAre WA VIN# 5TDDCRFH4GS020057 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. N#. 43 RLR 'I GoI VEH YEAR 2016 MAKE 7'Dy7' MODEL yIGHLAN STYLE UT —YEHICLE TOWED NOO✓ BLIN TOWED BY v HYES NO 44 24❑ fj REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#E CO FARMERS INS 187777689IN IU STOP 'E""LE CITATION# CHARGE o BOTTOMLEGALLYYES NEI25❑ J OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF84739 COLLISION REPORT III III III III III 111 1591972 CASE# 25-3398 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) BERNO GALLO CESAR A (LAST FIRST, ADDRESS&PHONE# 17051 151ST AVE SE RENTON WA 98058 4085696473 SEX M MMDOYyry 11 - 17 - 1980 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES Z; PQS. USE CLASS NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS R PHONE# SEX D.Q.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.ARNOLD 04-15-25 01:38 PM NVESTIGATING QFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE M.LEVERTON 2517 1 412212025 2:39:01 PM BADGE OR ID# 12509 OR]#` WA0171300 TIME POLICE DISPATCHED 12:15 PM TIME POLICE ARRIVED]12:24 pM PART I PAGE IT]OF 4� REPORT NO. EF84739 CASE# 25-3398 OF COLLISION 04/15/25 12:14 OF CbLLI510N NARRATIVE CC 25-3398 On 4/15/2025 at 1215 hours I was dispatched to a motor vehicle collision at the intersection of S 43rd St and Talbot Rd S in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that she was in the #2 lane of S 43rd St facing East and came to a stop for an ambulance that was proceeding South on Talbot Rd S, crossing over S 43rd St. Driver 1 stated that he was approaching the intersection of S 43rd St and Talbot Rd S in the #2 lane and saw that he had a green light. Collision Driver 2 stated that as she was stopped, the front passenger side bumper of Unit 1 collided with the rear drivers side bumper of Unit 2. Driver 1 stated that as he approached the intersection, he was not paying attention and did not see the ambulance and that traffic was stopped. Driver 1 stated that he attempted to swerve to avoid a collision but miscalculated his movement and the front passenger side bumper of Unit 1 collided with the rear drivers side bumper of Unit 2. Injuries Neither driver complained of injuries. Vehicle Disposition Unit 1 was rendered inoperable and towed from the scene. Unit 2 was able to be driven to a nearby parking lot. Proximate Cause I determined that the proximate cause for this collision was Driver 1 because Driver 1 failed to use the appropriate attentiveness to the presence of traffic around him. Had Driver 1 been attentive, this collision would not have happened. Driver 1 was cited per RMC 10-12-25 for Inattentive Driving. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer C. Arnold #12509 at 13:23 on 4/15/2025 in the City of Renton, King County, Washington. PAGE 3 OF 4 REPORT NO. EF84739 CASE# ' 25-3398 DATE AND TIME 04/15/25 12:14 OF COLLISION ?' E �3 �t t4��ka it� t x F s S { t 1 l i PAGE 4 OF 4